Osteoporosis Advice

[sahuaro]

Allan:
I don't understand why your pharmacist said there is no bone growth in adults--they may not get longer (you don't get taller), but bone is living tissue and there is (or should be) turnover in the cells (like skin).

I have had an increase in bone density as measured by DEXA with Actonel and calcium and vitamin D supplements and my PCP said that he has patients with greater increases than mine.

I have not done the research but I too would question the effects of a once-a-year massive dose as opposed to weekly dosage. Your numbers seem to be right on the border between osteopenia and osteoporosis--I know you can be obsessive about these things (), but maybe a consult with a rheumatologist to ask about options?

[ans]

Thanks Dale: if only I could weight-lift!

Barbara, thank you so much for your advice/information. I knew that I could count on you to figure the stats as they are not in t-scores. (Or are they? I'm dumb in stats).

I appreciate your update on bone growth! Why should I see a rheumatologist when I have you as my consult?

Hmm, so whaddy'a think would be the best treatment. Fosomax? (Now I wonder if there's truly a generic) or Actonel like yourself? I need ammunition before I see my internist who told me that w/one of these drugs I'd have to inject myself every day? He's smart and rarely wrong but I suspect this time, something's awry.

Wow, so I'm not in the pure osteoporosis range? Geeze, it's so unlike me to worry or catastrophize.

In appreciation oh science fair whiz.

Allan

[sahuaro]

Fossomax and Actonel are both in pill form; it is the Forteo that requires injection. For some reason, I re-read the patient insert for Actonel this morning and it comes in different doses for daily, weekly and twice-monthly administration. I don't know why one would be chosen over the others--but I think I would rebel against the daily dose. I am on Actonel because I was having GI problems on the Fossomax. Otherwise, I don't know if there's any advantage of one over the other. Also, from what I've gathered from other people's posts, Forteo is a different kind of medication than the biophosphanates (sp?): you take it for a couple of years and then switch to the biophosphanates.

[Maria]

ans,

Please the part particularly about oseoblasts/osteoclasts

FYI~ the injectable Forteo is not like drawing up a syringe of medication and injecting one's self intramuscularly. It's done with a pen system and a very small fine needle on a pen type of system and all you have to do is grasp a little roll of fat (like around the stomach) and subcutaneously inject the medication by pulling back on the base of the pen system (like the needle) and pushing this very slender tiny needle into the sub-q fat and then it's advised to count to five which I sometimes do or not and withdraw the needle.

To me the worse thing about this is remembering to do it daily and the smell of the medication which isn't bad just sometimes sticks with me for some reason.

While I googled this info it seemed to be correct,succinct and pertinent to the question asked. Read on...

Edit by mmglobal 3/15/013 following a copyright infringement complaint. I'm adding appropriate citing of source below.

The following information was excerpted from an article titled,
"How bones work — the nature of healthy bone" by Dr. Susan E. Brown, PhD
at The nature of healthy bone

Edit 3/19/2013, removed quoted text because of copyright infringement complaint. Mark

[sahuaro]

Excellent info, Maria. Thank you for posting this.
Collagen--interesting and makes sense.

[ans]

Thank you very much for helping me!

I remember now the bone stuff from physiology.

Spotty from another forum told me that the bone being built isn't as dense as normal bone - but as M points out, we have various bone types.

I"m going for a hip MRI pretty soon and also for my spine as the pain's getting worse, day by day.

So, can you think for me and tell me what to do? I"m not kidding!

Yeah, so the hematologist/oncologist wanted to give me a yearly infusion of Reclast. Spotty is also concerned that these drugs last for 20 years (in the bone marrow?) and we don't know much about their safety. Maybe this is regarding an infusion versus more regular doses.

Is it true that Forteo is in generic b/c I was told that it's very expensive.

Again, I appreciate this as this is a new world.

(I wonder if I was born intersexed b/c of this).

Barbara, so you are interpreting the standard deviations and putting them in light of T-scores? I'll have to ask you sometime how this is done.

Gratefully, Allan

[sahuaro]

Allan:
Osteoporosis is defined as T scores below -2.5. T scores compare your bone density to women in their 30's (yes, women); Z scores compare to women in your age range. I don't know if the interpretation of scores is adjusted for males, e.g., if, as a male, a T score of -2.5 would be interpreted as worse than the same score for a woman. Obviously, in many ways, this is a crude measure and docs don't figure in the standard error of measurement and other variables.
Since you have had previous tests, the question would be whether the change in your scores are within the standard error of measurement or beyond, i.e., is the change significant? (I don't remember the SE but I did find it online a while ago)